Intended for healthcare professionals


Managing chronic pain in children and adolescents

BMJ 2003; 326 doi: (Published 26 June 2003) Cite this as: BMJ 2003;326:1408
  1. Christopher Eccleston (, director,
  2. Peter Malleson, professor of paediatrics
  1. Pain Management Unit, University of Bath and Royal National Hospital for Rheumatic Diseases NHS Trust, Bath BA2 7AY
  2. Division of Paediatric Rheumatology, University of British Columbia V6H 3V4, Canada

    We need to address the embarrassing lack of data for this common problem

    Recent epidemiological data have made nonsense of the prejudice that chronic pain is a uniquely adult problem. Chronic and recurrent pain in children and adolescents is now known to have a point prevalence of at least 15%.1 Girls report more pain than boys, and the incidence peaks at an average age of 14 years. The most common complaint is headache, followed by recurrent abdominal pain and musculoskeletal pain.2

    Many of the children and adolescents with chronic and recurrent pain will be managed effectively by the family doctor or may simply never come to professional attention. However, a noteworthy number of children and their families are severely affected by pain. Doctors concerned about missing a serious underlying disease invest time and energy in investigating the child and referring to specialists for further evaluation. During the time spent in this “diagnostic vacuum,” the child often receives little appropriate pain management. If, as is usually the case, no specific cause can be found the child, family, and doctor often become frustrated, sometimes antagonistic towards each other, and the management of the pain goes wanting. It is this time spent in the search for …

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